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PubMed2005

Visual exploration of landmarks and trends in the medical informatics literature.

This study presents preliminary results from a visual study of a new dataset of forty years of citation data from publications of twelve journals in the medical informatics field covering the time period from 1964-2004. Highly cited and pivotal documents, areas of specialization within medical informatics, and emergence of research topics are visually mapped through a progressive knowledge domain visualization approach to detecting and visualizing trends and patterns in scientific literature.

Bibliometrics↗
PubMedDate not supplied

Standards for medical identifiers, codes, and messages needed to create an efficient computer-stored medical record. American Medical Informatics Association.

A major obstacle to establishing a computer-stored medical record is the lack of "standards" that would permit government, care providers, insurance companies, and medical computer system developers to share patient data easily. In this position paper, the Board of Directors of the American Medical Informatics Association recommends specific approaches to standardization in the areas of patient, provider, and site of care identifiers; computerized health care message exchange; medical record content and structure, and medical codes and terminologies. The key concept developed in this position paper is that developers and users of computer-stored medical records must embrace existing and tested approaches, despite their imperfections, to progress quickly. This approach to standardization is being coordinated with the American National Standards Institute's Health Informatics Standards Planning Panel. The development of standards is a long-term process involving continued refinement. The proposed standards are an important step toward the goal of better and more efficient health care.

Association↗
PubMed1983

Training in medical informatics.

A course is described for the training of medical students in medical informatics (other terms: computational medicine, medical computing). The philosophy behind the course is that there are several modes or levels of human interaction in working with computers, running from registrative functions to assistance at diagnosis and therapy. The course, which consists of five full days, contains lessons in the areas of medical data bases, hospital information systems, medical records, biological signal analysis, computer-assisted diagnosis making, and patient simulation by CAI. Each group of two students has a terminal available, connected to a mini- and/or a microcomputer. The microprocessor takes care of signal analysis and the minicomputer is available for data base construction and interactive operations. The article describes the purposes and contents of all different lessons of this course.

Computer-Assisted Instruction↗
PubMed2005

Defining and assessing medical informatics competencies.

As academic health sciences libraries assume larger roles in informatics instruction within medical school curricula, librarians are challenged to develop useful and accurate measures for assessing the effectiveness of instructional approaches. The need for this evaluation has intensified as medical schools increase their emphasis on integration of curriculum content and shift to competency-based education and assessment of medical students. This paper reports on a pilot project developed at Dahlgren Memorial Library, Georgetown University Medical Center, for two courses using an instructional intervention and tailored assignment for assessing student competencies.

Competency-Based Education↗
PubMed1997

Re-imagining the medical informatics curriculum.

Most physicians in academics, administration, and private practice are insufficiently trained to cope with the current challenges facing medicine. Although information technology, and medical informatics in particular, has been considered to be part of the solution to this problem, the philosophical underpinnings of informatics remain a source of much discussion. Too often, new technology is seen as a new way to do the same things, rather than as an opportunity for a radical reenvisioning of the processes and practices themselves. As a consequence, practitioners and educators fail to make the best uses of new technologies, and fail to offer medical students the comprehensive training in medical informatics that they will need as they move into the real worlds of practice and academics. In this paper, the author describes an imaginary informatics curriculum made up of six core courses: Introduction to Complexity, Decisions and Outcomes, Scarcity and Conflict, Teamwork and Organizations, Representing Knowledge and Action, and Groupware and Collaboration. He does not recommend that these hypothetical courses actually be implemented, but presents them in the hope that they may serve as a starting point for discussions of how informatics can be incorporated into the curriculum in a more substantive way.

Curriculum↗
PubMed2001

Training in medical informatics: combining onsite and online instruction.

The Internet is promoting active exchange of teaching materials and discussion among geographically distant collaborators. We envision that training in medical informatics can be better achieved if both onsite and online instruction are combined, provided that cultural and technological barriers are anticipated and the training program is prepared accordingly. We describe our Brazil/USA program in medical informatics, which includes components of on-site and online education, and discuss lessons learned during its ongoing implementation. Three onsite courses and one workshop have been planned, and two online courses are being developed.

Brazil↗
PubMed2004

Medical informatics standards applicable to emergency department information systems: making sense of the jumble.

The adoption of medical informatics standards by emergency department information systems (EDISs) is not universal, despite obvious benefits. Clinicians and administrators looking to obtain an EDIS need to know exactly what the various standards can do for them and how the systems they depend on can be integrated and extended. In addition to the standard methods for systems to communicate (chiefly Health Level 7 [HL7]) and those required for submission of claims (Current Procedural Terminology [CPT]-4, International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM], and X12N), there are several other available standards that are clinically useful and can greatly improve the ability to access and exchange patient information. Major advances in the Unified Medical Language System of the National Library of Medicine have made the patient medical record information standards (Systematized Nomenclature of Medicine [SNOMED], Logical Observation Identifiers, Names, and Codes [LOINC], RxNorm) easily accessible. Detailed knowledge of the arcana associated with the technical aspects of the standards is not needed (or desired) by clinicians to use standards-based systems. However, some knowledge about the commonly used standards is helpful in choosing an EDIS, interfacing the EDIS with the other hospital information systems, extending or upgrading systems, and adopting decision support technologies.

Humans↗
PubMed2004

Milestones in Romanian medical informatics.

The paper concerns the major activities in the field of medical informatics in Romania: education, computer technology, implementation in healthcare, role of industry, IT use in medical applications and research.

Hospital Information Systems↗
PubMed1994

Medical informatics conference papers: a content analysis of research in a new discipline.

One of the hallmarks of a mature discipline is a varied and robust body of literature describing the research activities of the discipline. Medical informatics has rapidly become an accepted scientific discipline, having emerged from two long established disciplines (medical and computer science). This study looks at one form of scientific communication as a descriptive indicator of the maturity of medical informatics as a discipline. Conference proceedings were selected because they represent one of the first means of communication within a discipline in a semiformal format. Findings confirm that conference papers report research, development, and application projects across a wide range of topics; identify a possible trend toward increased funding; and show widespread use of empirical and quantitative research and analytical techniques. Deficiencies in the conference papers are also discussed.

Congresses as Topic↗
PubMedDate not supplied

Human meaning of medical informatics: reflections on its future and trends.

The philosophy underlying medical informatics, and indeed information systems in general, is discussed. The need for integrating concepts is considered, and particular emphasis is placed on the avoidance of fragmentation and overspecialization. Human and artificial intelligence are compared and contrasted. It is shown that human intellectual activity cannot be reduced to a set of formal computations. The main emphasis of this paper is that the unique properties of human intelligence should not be devalued or ignored in attempts to promote machine systems in unappropriate areas.

Artificial Intelligence↗
PubMed2001

A survey of academic and industry professionals regarding the preferred skillset of graduates of medical informatics programs.

Identification of the skills needed by graduates of medical informatics masters degree programs is needed so that students will know what is desired in the workplace and curriculum designers can assure that courses cover relevant areas. We conducted a mail survey of representatives of the informatics job market to discover what they think is most important. A survey instrument was designed after analyses of job ads and curricula in the U.S. and interviews with representative employers. The survey was mailed to 1000 randomly selected members of AMIA and HIMMS plus EMR vendors. Respondents were asked to rank skills and groups of skills according to perceived utility. The results indicate higher rankings for organizational and interpersonal skills than for more technical credentials. Statistical analysis indicates the existence of relatively few underlying constructs to the skill list.

Data Collection↗
PubMedDate not supplied

Medical informatics and the science of cognition.

Recent developments in medical informatics research have afforded possibilities for great advances in health care delivery. These exciting opportunities also present formidable challenges to the implementation and integration of technologies in the workplace. As in most domains, there is a gulf between technologic artifacts and end users. Since medical practice is a human endeavor, there is a need for bridging disciplines to enable clinicians to benefit from rapid technologic advances. This is turn necessitates a broadening of disciplinary boundaries to consider cognitive and social factors pertaining to the design and use of technology. The authors argue for a place of prominence for cognitive science. Cognitive science provides a framework for the analysis and modeling of complex human performance and has considerable applicability to a range of issues in informatics. Its methods have been employed to illuminate different facets of design and implementation. This approach has also yielded insights into the mechanisms and processes involved in collaborative design. Cognitive scientific methods and theories are illustrated in the context of two examples that examine human-computer interaction in medical contexts and computer-mediated collaborative processes. The framework outlined in this paper can be used to refine the process of iterative design, end-user training, and productive practice.

Cognitive Science↗
PubMed1996

The questions of medical informatics.

Each science is identified with the questions it raises with respect to its object of study. This paper discussed the formulation of the basic questions of medical informatics. From a historical point of view, it first dealt with the problems of medical computing. Thereby, three classical questions arose: How can existing computers and information technologies assist in medical activities? Which components of the mathematical apparatus of informatics can be used for solving medical problems, and how and what activities of a physician are subject to algoritmization? The present time raises a new circle of questions centered around the basic one: How is the information system of the human organism structured and how does it function? This question and others form the basis of a new trend in medical informatics.

Algorithms↗
PubMed2002

Medical informatics education: an alternative pathway for training informationists.

Recognition of the growing complexity of health information needs has led to a call for the creation of a new health care professional, the informationist. Controversy exists as to the role of such individuals and what their training should be. A library science degree, augmented with clinical background or experience, is one pathway. Another to consider is training in medical informatics. With the right coursework, individuals trained in medical informatics should be equally well qualified to assume the role of informationists.

Career Choice↗
PubMed1995

American College of Physicians (ACP) medical informatics and telemedicine.

The American College of Physicians (ACP) is the largest speciality society in the United States with over 83,000 Internal Medicine physician members. ACP seeks to be the foremost comprehensive education and information resource for all internists in support of its mission "to enhance the quality and effectiveness of health care." Medical Informatics and telemedicine is an integral part of the American College of Physicians' strategy to achieve its goals. ACP Medical Informatics Subcommittee and staff develop ACP policies and programs to improve clinical care and medical education through the use of Information Systems and new technologies for managing and integrating medical information and knowledge. This paper describes present and planned ACP informatics and telemedicine programs and projects focussing particularly on strategies to meet physicians' information needs incident to their patient care activities.

Forecasting↗
PubMed2004

An international course on strategic information management for medical informatics students: international perspectives and evaluation.

All over the world, countries more and more take part in the international society and economy. To meet the stringent requirements of this globalization asks for internationally oriented and well-educated graduates. A major challenge of academia thus lies in qualifying graduates for international positions in this new world. A crucial element in the training and education of tomorrow's medical informatics specialists is exposure to health care systems across national borders. In this contribution, we report on the international aspects of and experiences with an inter-university course for medical informatics students on hospital information systems, in particular on their strategic information management. From 2001 onwards, this course was offered jointly for students of the University of Amsterdam, the University of Heidelberg/University of Applied Sciences Heilbronn and the University of Health Informatics and Technology, Tyrol (UMIT). Based on our experiences, future establishment of international courses in the medical and health informatics field is recommended.

Austria↗
PubMed2001

Hickam 2000: the maturation of, and linkages between, medical informatics and bioinformatics.

I have always been infatuated with computers and convinced of their potential for solving problems in biologic research and clinical care. In the 1960s I thought we could use the computer to predict the shape of macromolecules from their chemical formulas and fundamental physical chemical principles. However, with the computers of the 1960s that was a fantasy. So I focused on the use of computers to manage medical record content and to assist with clinical care. The Electronic Medical Record (EMR) we began developing in 1972 with 33 diabetes patients now carries nearly 300 million separate results for more than 3 million patients. The data include lab and other diagnostic studies, dictated notes, orders, encounter records, radiology images, electrocardiograph tracings, and motion cardiac echoes, and the care provider at Indiana University and Wishard Hospital is accessed 10 million times per year. We have also agitated for standards to make the collection of these data easier. This work has become part of a field called medical informatics. In the meantime, the application of computers to biology has rapidly matured into a field called bioinformatics, and researchers in this field now provide annotated databases for many categories of molecules, programs for "matching" newly discovered genomic sequences with previously studied sequences, and systems for storing and processing massive amounts of genomic and molemic data. They have developed sophisticated methods for predicting the shape of biologic macromolecules and other important insights about biology and evolution. Medical informatics and bioinformatics intersect at many points. The most important intersection is between electronic medical records and the human specimen databases that can link genotype to the phenotype, as needed, to unravel polygenetic disease causality. The National Cancer Institute is embarking on an intriguing effort to use EMRs (phenotype) to link to paraffin blocks (genotype) in pathology laboratories where opportunities for cancer genomic discovery are open. We will participate in this effort and look forward to bending the EMR we developed for clinical use to bioinformatics uses as well.

Clinical Medicine↗